Mapping global trends in vaccine confidence and investigating barriers to vaccine uptake: a large-scale retrospective temporal modelling study.
Mapping global trends in vaccine confidence and investigating barriers to vaccine uptake: a large-scale retrospective temporal modelling study.
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DOI：
10.1016/s0140-6736(20)31558-0
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发表时间：
2020-09-26
期刊：
影响因子：
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通讯作者：
Larson HJ
中科院分区：
文献类型：
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作者：
de Figueiredo A;Simas C;Karafillakis E;Paterson P;Larson HJ
越来越多的证据表明，由于对疫苗的重要性、安全性或有效性缺乏信任，以及持续存在的获取问题，疫苗接种被推迟或拒绝。尽管世界各地的免疫接种覆盖率都有行政报告，但没有类似的强有力的疫苗信心监测系统。在这项研究中，疫苗信心在2015年至2019年期间在149个国家进行了映射。在这项大规模的回顾性数据驱动分析中，我们使用2015年9月至2019年12月期间在149个国家进行的290项调查的数据，研究了疫苗信心的全球趋势，其中包括284381名个人。 我们使用贝叶斯多项logit高斯过程模型来估计公众对疫苗安全性，重要性和有效性的看法。使用单变量贝叶斯逻辑回归确定疫苗摄取与大量假定的摄取驱动因素之间的关联，包括疫苗信心、社会经济地位和信任来源。吉布斯抽样用于贝叶斯模型推断，95%贝叶斯最高后验密度区间用于捕获不确定性。在2015年11月至2019年12月期间，我们估计阿富汗、印度尼西亚、巴基斯坦、菲律宾和韩国对疫苗的重要性、安全性和有效性的信心下降。我们发现，2015年至2019年期间，在阿富汗、阿塞拜疆、印度尼西亚、尼日利亚、巴基斯坦和塞尔维亚等六个国家，强烈反对疫苗安全的受访者人数显著增加。我们发现，2018年至2019年，包括芬兰、法国、爱尔兰和意大利在内的一些欧盟成员国的信心有所改善，波兰的信心最近有所下降。与考虑的其他决定因素相比，对疫苗重要性（而不是其安全性或有效性）的信心与疫苗接种的单变量关联最强。当发现个人的宗教信仰与吸收之间存在联系时，研究结果表明，少数宗教群体的吸收概率往往较低。据我们所知，这是迄今为止最大规模的全球疫苗信心研究，可以进行跨国比较和随时间的变化。我们的研究结果强调了定期监测的重要性，以发现新出现的趋势，以促进干预措施，建立和维持疫苗的信心。欧洲委员会、威康、工程和物理科学研究理事会。
There is growing evidence of vaccine delays or refusals due to a lack of trust in the importance, safety, or effectiveness of vaccines, alongside persisting access issues. Although immunisation coverage is reported administratively across the world, no similarly robust monitoring system exists for vaccine confidence. In this study, vaccine confidence was mapped across 149 countries between 2015 and 2019. In this large-scale retrospective data-driven analysis, we examined global trends in vaccine confidence using data from 290 surveys done between September, 2015, and December, 2019, across 149 countries, and including 284 381 individuals. We used a Bayesian multinomial logit Gaussian process model to produce estimates of public perceptions towards the safety, importance, and effectiveness of vaccines. Associations between vaccine uptake and a large range of putative drivers of uptake, including vaccine confidence, socioeconomic status, and sources of trust, were determined using univariate Bayesian logistic regressions. Gibbs sampling was used for Bayesian model inference, with 95% Bayesian highest posterior density intervals used to capture uncertainty. Between November, 2015, and December, 2019, we estimate that confidence in the importance, safety, and effectiveness of vaccines fell in Afghanistan, Indonesia, Pakistan, the Philippines, and South Korea. We found significant increases in respondents strongly disagreeing that vaccines are safe between 2015 and 2019 in six countries: Afghanistan, Azerbaijan, Indonesia, Nigeria, Pakistan, and Serbia. We find signs that confidence has improved between 2018 and 2019 in some EU member states, including Finland, France, Ireland, and Italy, with recent losses detected in Poland. Confidence in the importance of vaccines (rather than in their safety or effectiveness) had the strongest univariate association with vaccine uptake compared with other determinants considered. When a link was found between individuals' religious beliefs and uptake, findings indicated that minority religious groups tended to have lower probabilities of uptake. To our knowledge, this is the largest study of global vaccine confidence to date, allowing for cross-country comparisons and changes over time. Our findings highlight the importance of regular monitoring to detect emerging trends to prompt interventions to build and sustain vaccine confidence. European Commission, Wellcome, and Engineering and Physical Sciences Research Council.